Assessment of Task Demand and Usability of a Virtual Reality-Based Rehabilitation Protocol for Combat Related Traumatic Brain Injury From the Perspective of Veterans Affairs Healthcare Providers: A Pilot Study

The risk of traumatic brain injury (TBI) is significantly higher among Veterans compared to non- Veterans. Access to treatment for TBI and post concussive symptoms is sometimes difficult, because of barriers related to distance, finances, and public safety (i.e., COVID-19 infection). Virtual reality rehabilitation (VRR) offers an opportunity to incorporate a virtual space into a rehabilitation environment. To our knowledge, VRR has not been used to assist Veterans with TBI and related health problems with Instrumental Activities of Daily Living (iADLs). The purpose of this study is to investigate the usability of a novel VRR ADL and iADL training protocols, developed by the Gaming Research Integration for Learning Laboratory (GRILL®) at the Air Force Research Laboratory, for cognitive rehabilitation for Veterans with a TBI. We deployed a prototype protocol among healthcare providers (n = 20) to obtain feedback on usability, task demand, and recommended adjustments. Our preliminary analysis shows that providers found the VRR protocol involved low physical demand and would likely recommend it to their patients. Although they had some concerns with vertigo-like symptoms from using a digital technology, they believed the protocol would improve iADL functioning and was a good addition to pre-existing rehabilitation protocols. These outcomes provide justification for more impactful studies investigating the effectiveness of this protocol among Veterans with TBI. Copyright © 2021 Greenhalgh, Fitzpatrick, Rodabaugh, Madrigal, Timmerman, Chung, Ahuja, Kennedy, Harris and Adamson.

An examination of bedtime media and excessive screen time by Canadian preschoolers during the COVID-19 pandemic.

BACKGROUND: Risky media use in terms of accumulating too much time in front of screens and usage before bedtime in early childhood is linked to developmental delays, reduced sleep quality, and unhealthy media use in later childhood and adulthood. For this reason, we examine patterns of media use in pre-school children and the extent to which child and family characteristics contribute to media use during the COVID-19 pandemic. METHODS: A cross-sectional study of digital media use by Canadian preschool-aged children (mean age = 3.45, N = 316) was conducted at the start of the COVID-19 pandemic between April and August of 2020. Parents completed a questionnaire and 24-h recall diary in the context of an ongoing study of child digital media use. From these responses we estimated hours of average daily screen time, screen time in the past 24 h, average daily mobile device use, and media use before bedtime. Parents also answered questions about their child (i.e., age, sex, temperament), family characteristics (parental mediation style, parental screen time, education, income), and contextual features of the pandemic (ex., remote work, shared childcare). Daycare closures were directly assessed using a government website. RESULTS: Our results indicate that 64% of preschoolers used more than 2 h of digital media hours/day on average during the pandemic. A majority (56%) of children were also exposed to media within the hour before bedtime. Logistic and multinomial regressions revealed that child age and temperament, restrictive parental mediation, as well as parent digital media use, education, satisfaction with the division of childcare, remote work, and number of siblings and family income were all correlates of risky digital media use by preschoolers. CONCLUSIONS: Our results suggest widespread risky media use by preschoolers during the pandemic. Parenting practices that include using more restrictive mediation strategies may foster benefits in regulating young children's screen time.

Linking High School Students’ Achievement Goal Orientations With Their Competence Beliefs and Their Perception of Teachers’ Emotional Support During the COVID-19 Pandemic

Due to the COVID-19 pandemic, adolescents have experienced limitations in their everyday activities. Consequently, their mental health has become an area of concern. However, there has been much less of a focus on the factors and mechanisms contributing to how they have approached their various academic activities during the pandemic. The current study fills this gap by investigating associations between adolescents’ competence beliefs and perception of teachers’ emotional support and their achievement goals (mastery, performance, and work avoidance) at the onset of the second wave of this pandemic in Canada. Participants were 90 Canadian high school adolescents in grades 9 and 10 and they were surveyed in November of 2020. Data were analyzed using multiple regression and mediation analyses. Among the most salient results, competence beliefs were found to predict achievement goals, above and beyond teachers’ emotional support, and these beliefs were significantly and positively associated with mastery and performance orientation, and marginally and negatively associated with work avoidance orientation. Results also showed that competence beliefs mediated the association between teachers’ emotional support and the mastery goal orientation. These findings are discussed in light of relevant pre-pandemic evidence about the role of competence beliefs and teachers’ emotional support on achievement goal orientations. Copyright © 2022 Smith, Nadeau, Archambault, Guimond, St-Amand, Fitzpatrick and Gagnon.

HIV-1 transmitted drug resistance and non-B subtype prevalence from a clinic-based population in Brighton, UK

Background: Using the WHO TDR list, we aimed to determine from our clinic database;the prevalence of TDR, non-B subtype and associated features in our large tertiary HIV department (∼2500 patients) from 2014-2020. Method: Using the WHO TDR list, we aimed to determine from our clinic database;the prevalence of TDR, non-B subtype and associated features in our large tertiary HIV department (∼2500 patients) from 2014-2020. Results: Of the 218 new diagnoses, 217 had a resistance test attempted (1 stored due to COVID-19). 212/217 had an available genotype (5 failed to amplify). 191/212(90%) were MSM, 12/212(6%) cis-female, 80/212(38%) non-UK born and the median age was 36 years (IQR = 29-46). The overall prevalence of TDR was 17/212(8%;95%CI = 5.0-12.4), seven (3%) had a NRTI mutation, six (3%) had at least one nNRTI mutation and 4(2%) had a PI mutation. There were no dual/triple class/INI mutations. There was no significant change in the prevalence of TDR over the study period. The overall prevalence of non-B subtype was 53/212(25%;95%CI = 19.6-31.2), and was not more frequently seen in non-UK born individuals (OR = 1.24;CI = 0.66-2.33, P = 0.51). Patients with TDR were older [45.v.36 years, P = 0.006] and have non-B subtype (OR = 2.96;CI = 1.08-8.13, P = 0.03). Although overall rates of bacterial STIs was high (34%), having a bacterial STI was not associated with TDR(OR = 1.77;95%CI = 0.66-4.82, P = 0.26). Conclusion: TDR is associated with age and non-B subtype in our population. HIV TDR is not decreasing locally and remains a small but significant concern despite effective HIV prevention strategies, which may not reach hidden populations affected by HIV. Continued efforts to reduce HIV transmission must target hidden populations and we must maintain adequate surveillance of TDR.

HIV-1 transmitted drug resistance between 2014-2020 in a HIV large population in Brighton, UK

Background HIV-1 transmitted drug resistance (TDR) is associated with sexually transmitted infections (STIs) and sexual clusters including MSM and non-MSM. TDR can lead to antiretroviral failure, and therefore UK guidelines recommend TDR testing in all new HIV patients. Subtype B is most common in urbanised western populations however is decreasing in proportion. Within the UK TDR is estimated to be 7.5% and non-B subtype 51%. Methods Using the WHO TDR list, we aimed to determine from our clinic database;the prevalence of TDR, non-B subtype and associated features in our large tertiary HIV department (∼2500 patients) from 2014-2020. Results Of the 218 new diagnoses, 217 had a resistance test attempted (1 stored due to COVID-19). 212/217 had an available genotype (5 failed to amplify).. 191/212(90%) were MSM, 12/212(6%) cis-female, 80/212(38%) non-UK born and the median age was 36 years (IQR=29-46). The overall prevalence of TDR was 17/212(8%;95%CI=5.0-12.4), seven (3%) had a NRTI mutation, six (3%) had at least one nNRTI mutation and 4(2%) had a PI mutation. There were no dual/triple class/INI mutations. There was no significant change in the prevalence of TDR over the study period. The overall prevalence of non-B subtype was 53/212(25%;95% CI=19.6-31.2), and was not more frequently seen in non- UK born individuals (OR=1.24;CI=0.66-2.33,p=0.51). Patients with TDR were older [45.v.36 years, p=0.006] and have non-B subtype (OR=2.96;CI=1.08-8.13,p=0.03). Although overall rates of bacterial STIs was high (34%), having a bacterial STI was not associated with TDR (OR=1.77;95%CI=0.66-4.82,p=0.26). Conclusion TDR is associated with age and non-B subtype in our population. HIV TDR is not decreasing locally and remains a small but significant concern despite effective HIV prevention strategies, which may not reach hidden populations affected by HIV. Continued efforts to reduce HIV transmission must target hidden populations and we must maintain adequate surveillance of TDR.

Understanding the impact of isolation due to COVID-19 on employment for Kentuckians with spinal cord injuries

BACKGROUND: Obtaining and retaining employment for persons with spinal cord injury (SCI) is frequently a greater challenge than it is for the non-SCI population. It is particularly difficult during COVID-19 because all the barriers to employment are compounded for people with SCI as they have to take extra precaution to protect their health and wellbeing. OBJECTIVE: The objective of the study was to understand how isolation related to COVID-19 has had an effect on the employment experiences for persons living with SCI. METHODS: Three virtual focus groups were conducted with Kentuckians who had SCI. RESULTS: The major themes were: the impact of disruption in routine on physical and mental health, importance of having the right accommodations, working from home as an accommodation, and the uncertainty of work. CONCLUSIONS: Accommodations are a critical component for people with SCI to be retained in the workforce. Employers should be proactive in offering various inclusive and accessible accommodations to employees so that people do not have to bear the additional burden of asking for accommodations. Rehabilitation professionals would serve the SCI population well by finding ways to help clients better advocate for themselves, provide adaptive home therapeutic equipment, and help identify diverse employment skill sets. © 2021 - IOS Press. All rights reserved.

Changes in Students' Achievement Motivation in the Context of the COVID-19 Pandemic: A Function of Extraversion/Introversion?

Students' mental health has been an increased concern since the outbreak of the COVID-19 pandemic. However, academic outcomes have received very little attention. In this study, changes in students' achievement motivation are investigated using an expectancy-value framework. Participants (n = 90) were high school students (grades 9 and 10) who reported on their expectancy and value perceptions in regard to learning before and during the pandemic (i.e., January and November 2020). Changes over time and as a function of extraversion/introversion were analyzed using repeated measures multivariate analyses of variance (MANOVAs). Most perceptions were found to be stable with the exception of interest in learning, which increased as a function of extraversion. Results are discussed in light of relevant pre-pandemic evidence.